Liu Xiao, Liu Hongbing, Li Chunhua, Wu Wenxia
Department of Otolaryngology Head and Neck Surgery，Second Affiliated Hospital of Nanchang University，Nanchang，330006，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Sep;34(9):805-810. doi: 10.13201/j.issn.2096-7993.2020.09.009.
To observe the microbiological characteristics and clinical correlation of chronic rhinosinusitis with different clinical phenotypes. One hundred and ninety-six patients with chronic rhinosinusitis（CRS） underwent nasal endoscopic surgery, including 126 patients with Chronic rhinosinusitis with nasal polyps（CRSwNP） and 70 patients with chronic rhinosinusitis without nasal polyps（CRSsNP）; 78 patients with nasal septum deviation（control group） were enrolled. The nasal discharge samples were collected before operation, and the bacteria were isolated and identified by the traditional culture method. The bacteria were compared between the two groups by Pearson chi-square test or Fisher exact test, and the bacteria were compared between groups by Kruskal-Wallis rank sum test. Out statistically significant variables（<0.05）. The total bacterial detection rate was 73.0% in the three groups, 76.2% in the CRSwNP group, 68.6% in the CRSsNP group and 71.8% in the control group, respectively（=0.579）. The detection rate of the bacteria was mainly Gram-positive bacteria. The higher detection rate included: Staphylococcus epidermidis, Pseudodiphtheria, Staphylococcus aureus, Haemophilus influenzaemola, Haemella influenzaemola. The detection rate of Haemophilus influenzae in the CRSwNP group and the control group（13.5% vs 2.6%, =0.009）, but there were statistical differences CRSsNP.There was no statistically significant difference in the detection rate of the bacteria（8.6% vs 2.6%, =0.15） between the CRSsNP group and the control group; The difference of staphylococcus aureus detection rate between NonECRSwNP group and ECRSwNP group was statistically significant （9.6% vs 28.1%,=0.017）.There was no significant difference in staphylococcus aureus detection rate between NonECRSsNP group and ECRSsNP group （9.4% vs 16.7%, =0.482）. Haemophilus influenzae may be a potential cause of CRSwNP; S. aureus may promote the eosinophilic granulocyte inflammatory response to CRSwNP.
观察不同临床表型慢性鼻-鼻窦炎的微生物学特征及临床相关性。196例慢性鼻-鼻窦炎（CRS）患者接受鼻内镜手术，其中慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者126例，慢性鼻-鼻窦炎不伴鼻息肉（CRSsNP）患者70例；纳入78例鼻中隔偏曲患者作为对照组。术前采集鼻分泌物样本，采用传统培养方法分离和鉴定细菌。两组间细菌比较采用Pearson卡方检验或Fisher确切概率法，多组间细菌比较采用Kruskal-Wallis秩和检验。筛选出具有统计学意义的变量（P<0.05）。三组总细菌检出率分别为73.0%，CRSwNP组为76.2%，CRSsNP组为68.6%，对照组为71.8%（P=0.579）。细菌检出以革兰阳性菌为主，较高检出率的有：表皮葡萄球菌、假白喉棒状杆菌、金黄色葡萄球菌、流感嗜血杆菌、溶血嗜血杆菌。CRSwNP组与对照组流感嗜血杆菌检出率有统计学差异（13.5% vs 2.6%，P=0.009），CRSsNP组无统计学差异；CRSsNP组与对照组细菌检出率无统计学差异（8.6% vs 2.6%，P=0.15）；非嗜酸粒细胞增多型CRSwNP组与嗜酸粒细胞增多型CRSwNP组金黄色葡萄球菌检出率差异有统计学意义（9.6% vs 28.1%，P=0.017）。非嗜酸粒细胞增多型CRSsNP组与嗜酸粒细胞增多型CRSsNP组金黄色葡萄球菌检出率无显著差异（9.4% vs 16.7%，P=0.482）。流感嗜血杆菌可能是CRSwNP的潜在病因；金黄色葡萄球菌可能促进CRSwNP的嗜酸粒细胞性炎症反应。
